Chronic Pain Blog

Updated October 4, 2026

Could medical cannabis help with chronic pain?

Some people living with chronic pain say it does. Others don't find much benefit. And the research doesn't give us a simple yes-or-no answer.
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Cannabis and cannabinoid-based products have received a lot of attention as possible treatments for chronic pain. Some people find them helpful, particularly for short-term symptom relief. But questions remain about how effective these products are over the longer term, which products are most helpful, who is most likely to benefit, and what risks come with their use.

Those are important questions.

Cannabis wasn't recommended by the Mayo Clinic when I attended its Pain Rehabilitation Center in 2018. The International Association for the Study of Pain (IASP) also does not endorse the general use of cannabis or cannabinoids for pain because it considers the available high-quality evidence insufficient. Importantly, IASP does not dismiss the experiences of people with pain who report benefit from these products. It recognizes the need for better research into both potential benefits and harms. [1]

What does the research show about effectiveness?
The research has become more informative in recent years, but it still doesn't give us a simple answer.

A 2025 systematic review examined 25 randomized controlled trials involving 2,303 people with chronic pain. Most of the studies were short-term, lasting one to six months, and 64% of participants had neuropathic pain.

The researchers found that some cannabinoid products produced small improvements in pain compared with placebo. Products containing higher amounts of THC produced a small reduction in pain, as did some products containing comparable amounts of THC and CBD.

But the size of the improvement was modest.

For example, the average reduction in pain was about 0.5 to 0.8 points on a 0-to-10 pain scale. The researchers also found increased risks of dizziness, sedation, and nausea with some of these products. CBD alone did not reduce pain compared with placebo. [2]

So what does that mean?

It doesn't mean cannabis or cannabinoids can never help anyone.

It means that, on average, the benefits demonstrated in clinical trials have been relatively small, and they have to be weighed against the potential side effects.

It also means we shouldn't assume that all cannabis products are alike.

Cannabis, THC, CBD, and cannabinoid-based medicines aren't interchangeable. Evidence for one product doesn't necessarily tell us whether another product will be effective.

And we still don't know enough about long-term effectiveness.

Most of the randomized trials included in the 2025 review lasted no more than six months. The researchers also found insufficient evidence to draw conclusions about whole-plant cannabis and several other products and comparisons. [2]

What about the placebo effect?
Another study provides an interesting perspective on the research.

A 2022 systematic review and meta-analysis published in JAMA Network Open examined 20 randomized clinical trials involving 1,459 people with clinical pain. The researchers found a substantial reduction in pain among people receiving placebo and did not find a statistically significant difference between cannabinoid and placebo groups. [3]

This doesn't mean people in the placebo groups were pretending to feel better.

Placebo effects can produce real changes in how symptoms are experienced.

The findings highlight something important about chronic pain treatment: expectations and the context surrounding a treatment can influence the experience of pain.

That's one reason rigorous placebo-controlled research is important when evaluating treatments for chronic pain.
It also helps explain why someone's personal experience with cannabis can be very real without necessarily telling us how effective the treatment will be for everyone.

There are risks to consider, too

​When discussing cannabis, it's easy to focus only on whether it might reduce pain. But a treatment decision should consider both potential benefits and potential harms.

The 2025 systematic review found increased risks of dizziness, sedation, and nausea with some cannabinoid products. Other research has also identified concerns involving drowsiness, impaired attention, cognitive effects, and other adverse events. [2,4]

And then there's the question of longer-term use.

A 2022 systematic review examining longer-term and serious harms of medical cannabis and cannabinoids for chronic pain found that adverse events were common, although the certainty of the evidence was very low. The authors also noted that longer studies tended to report more adverse events. [5]

That doesn't mean cannabis is unsafe for everyone. It means safety deserves just as much attention as effectiveness.

A new concern for older adults
This is particularly worth considering as cannabis use becomes more common among older adults.
A study published in Addiction in 2026 examined nationally representative U.S. survey data from 2021 through 2024 involving more than 21,000 adults age 65 and older.

The researchers estimated that 8.9% of older adults had used cannabis during the previous 12 months. Among those who had used cannabis during the previous year, 11.4% met criteria for cannabis use disorder. Most of those cases were classified as mild, with 20.1% moderate and 3.9% severe. [6]

The study also found that more frequent cannabis use was associated with a greater risk of cannabis use disorder.
This study needs to be put in context.

The researchers were studying cannabis use among older adults in general. They weren't studying people using medical cannabis specifically for chronic pain, and the study can't tell us that cannabis caused cannabis use disorder.

But it does tell us something important.

Cannabis use disorder isn't limited to younger people. It can occur among older adults, too.

That means the possibility of problematic use should be part of an honest conversation about cannabis, particularly when use becomes frequent.

The problem with relying on passive treatment
Medication can be an important part of chronic pain management for some people.

But relying primarily on passive treatments can have a downside.

When relief depends largely on a medication, procedure, or someone else providing the treatment, it can become easy to believe that pain relief depends on something being done for us.

That can make it harder to develop the knowledge, skills, confidence, and strategies needed to manage chronic pain independently.
This doesn't mean medication is bad or that people should never use it.

It means medication works best as part of a broader approach that also helps people develop active self-management skills.

Active approaches can include learning about pain, gradually increasing physical activity, addressing unhelpful thoughts and beliefs, improving sleep, developing coping strategies, and returning to meaningful activities.

The goal isn't to eliminate every passive treatment.

The goal is to avoid becoming dependent on passive treatment as the only way to manage chronic pain.

My experience
I have found that I don't need medication or supplements to manage my chronic pain.

Of course, that doesn't mean everyone will have the same experience. Mine certainly wasn't that way earlier in my pain journey.

My relief came from changing how I think about, feel about, and behave around pain through pain rehabilitation and self-management.
Instead of continually looking for something or someone to take the pain away, I learned skills that put more of the day-to-day management of chronic pain back in my own hands.

That shift from passive treatment to active self-management was an important part of my recovery.

It doesn't mean I believe everyone should stop taking medication or that medication has no place in chronic pain management.

Different treatments work differently for different people. Decisions about cannabis, medications, or other treatments should be made with a qualified healthcare professional who understands the individual's circumstances, other medications, and potential risks.

The goal is not to eliminate every treatment that might help. The goal is to make sure treatment supports the ability to manage life rather than becoming the only way someone believes chronic pain can be managed.

The bottom line
Cannabis and cannabinoid-based products remain an active area of research.

The current evidence suggests that some products can provide small short-term improvements in pain for some people with chronic pain. The evidence appears strongest for certain THC-containing products and some balanced THC-to-CBD products. At the same time, the benefits are generally modest, side effects are possible, and we still have important questions about long-term effectiveness and safety. [2]

CBD alone has not demonstrated the same pain-relieving benefit in the available clinical trials. And we shouldn't assume that an over-the-counter CBD product will have the same effects as a standardized cannabinoid-based medicine studied in a clinical trial. [2]

The new research on older adults adds another reason to consider the risks carefully. Cannabis use disorder can occur in older adults, and the risk appears to be greater among people who use cannabis frequently. [6]

So I don't think cannabis should be viewed as either a miracle treatment or something that can never help.

A better approach is to review the evidence, understand the potential benefits and risks, and consider whether it makes sense as part of an individualized treatment plan.

For people living with chronic pain, self-management doesn't mean refusing medication or other treatments.

It means developing the knowledge, skills, and confidence to actively manage chronic pain and live a meaningful life.

That was an important part of my own pain rehabilitation.

And ultimately, it helped me change the way I lived with chronic pain.

References

1. International Association for the Study of Pain. (2021). Cannabinoid non-technical summary 2021. https://www.iasp-pain.org/advocacy/iasp-statements/cannabinoid-non-technical-summary-2021/
2. Cannabis-Based Products for Chronic Pain: An Updated Systematic Review. (2025). Systematic review of randomized placebo-controlled trials evaluating cannabis-based products for chronic pain.
3. Gedin, F., Blomé, S., Pontén, M., et al. (2022). Placebo response and media attention in randomized clinical trials assessing cannabis-based therapies for pain: A systematic review and meta-analysis. JAMA Network Open, 5(11), e2243848.
4. McGuire, P., Robson, P., Cubala, W. J., et al. (2023). Balancing risks and benefits of cannabis use: Umbrella review of meta-analyses of randomised controlled trials and observational studies. BMJ, 382, e072348.
5. Wang, L., Hong, P. J., May, C., et al. (2022). Long-term and serious harms of medical cannabis and cannabinoids for chronic pain: A systematic review of non-randomised studies. BMJ Open, 12(8), e054282.
6. Han, B. H., Eschliman, E. L., Palamar, J. J., Triguero Roura, M., & Mauro, P. M. (2026). Cannabis use and cannabis use disorder among older adults in the USA. Addiction. https://doi.org/10.1111/add.70600.

Learn more

• Cannabinoid Non-technical Summary 2021 - International Association for the Study of Pain
• IASP Position Statement on the Use of Cannabinoids to Treat Pain - International Association for the Study of Pain
• Cannabis Is No Better Than a Placebo for Treating Pain - New Research
• Cannabis for Chronic Pain: New Research Questions Its Effectiveness
• Cannabidiol (CBD) Products for Pain: Ineffective, Expensive, and With Potential Harms
• What You Need to Know About Products Containing Cannabis or Cannabis-Derived Compounds, Including CBD
• Labeling Accuracy of Cannabidiol Extracts Sold Online
• Beware of supplements - Chronic Pain Champions
• We Have a Chronic Pain Problem, Not a Prescription Opioid Problem
• The Power of the Placebo Effect
• How to Move Patients from Passive Management to Active Self-Management

Updated 10/5/2026
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Did you know?

• About 84% of people experience low back pain at some point in their lives.
• Most low back pain is classified as non-specific, meaning no single specific structural cause can be identified.
• Serious underlying causes of low back pain are uncommon.
• Discs don't literally "slip." A disc can bulge or herniate, but it doesn't slide out of place.
• Most symptomatic lumbar disc herniations improve without surgery.
• Abnormal MRI findings are common - even in people who have little or no back pain.
• Psychological factors, including depression, can sometimes be more predictive of future outcomes than certain MRI findings.
• Most episodes of low back pain improve with time and conservative care.
• Recurrence is common: more than two-thirds of people who recover from an episode of low back pain experience another episode within 12 months.
• Back surgery does not always relieve pain and can sometimes be followed by persistent pain. Pasted markdown

Back pain and what an MRI can and can't tell you
Back pain can be scary, especially when an MRI reveals an abnormality. But structural findings on a scan don't necessarily explain the pain, identify its cause, or mean that a specific treatment will help.

Abnormal MRI findings are common in people without back pain, and they become more common with age. Disc degeneration, bulging discs, and other changes can appear on scans of people who have little or no pain. An abnormal MRI, by itself, doesn't tell you how much pain someone should have - or necessarily what is causing it.

Although chronic low back pain is common, a single specific structural cause can't be identified in many cases. This doesn't mean the pain isn't real. Pain is a biopsychosocial experience, with biological, psychological, and social factors that can all contribute to how pain develops, persists, and changes over time.

Fear of pain, stress, poor sleep, low mood, and avoiding movement can sometimes contribute to ongoing pain and disability. Understanding these factors can be an important part of learning how to manage back pain and move forward.

The good news? Chronic back pain doesn't necessarily mean that the back is damaged, fragile, or wearing out.

10 things worth knowing about chronic low back pain

1. Chronic back pain can be scary, but it is rarely dangerous. Chronic back pain can be distressing and disabling, but most cases aren't caused by a life-threatening condition or dangerous damage to the spine. Serious causes are uncommon. For most people, chronic back pain doesn't mean the spine is progressively deteriorating or that paralysis or a wheelchair is inevitable. That said, some symptoms require medical evaluation. New or progressive leg weakness, loss of bladder or bowel control, numbness around the groin or buttocks, fever, unexplained weight loss, significant trauma, or other concerning symptoms should be evaluated promptly. 
2. Getting older does not mean back pain is inevitable. Degenerative changes in the spine become more common with age, but aging itself doesn't mean back pain is inevitable. People of all ages can experience back pain and benefit from appropriate treatment, exercise, and strategies that help them remain active. An aging spine may look different on an MRI, but an older-looking spine doesn't automatically mean a more painful spine.
3. Chronic back pain is not necessarily a sign of ongoing tissue damage. Many injured tissues heal substantially within weeks to months. When pain continues beyond the expected period of tissue healing, however, other factors can contribute to the ongoing pain experience. Back pain can also begin without a significant injury or after ordinary activities such as bending, lifting, or exercising. Stress, poor sleep, fatigue, worry, inactivity, and unaccustomed activity can all influence how sensitive the body becomes to movement and loading. The pain is real. But chronic pain doesn't automatically mean that something is still being damaged.
4. Scans don't always show the cause of back pain. For uncomplicated low back pain, imaging isn't routinely needed and often doesn't change treatment. MRI scans can reveal many things that sound alarming - such as disc bulges, degeneration, protrusions, arthritis, and other age-related changes. Yet these findings are also common among people with little or no back pain. This is why an abnormal scan should be interpreted in the context of symptoms, examination, and the overall situation. A scan can show what the spine looks like. It can't, by itself, tell someone how much pain they should feel. Disc herniations can also change over time, and many improve or shrink without surgery.\
5. Pain with exercise and movement doesn't necessarily mean harm. When pain persists, the spine and surrounding tissues can become more sensitive to movement, touch, and loading. Pain during movement can reflect increased sensitivity rather than ongoing tissue damage. Pain doesn't automatically mean that movement is causing harm. For many people, gradually returning to movement and exercise is an important part of recovery. Starting at an appropriate level and gradually increasing activity can help build strength, confidence, and tolerance. In other words, movement can be part of the solution rather than something to fear.
6. There is no single "perfect" posture that prevents back pain. There's no need to maintain one perfect posture to protect the back. Sitting, standing, bending, and lifting in different positions are normal parts of everyday life. Some positions may be uncomfortable when the back is sensitive, but discomfort doesn't necessarily mean that the position is damaging the spine. Rather than constantly trying to maintain a "perfect" posture, focus on moving regularly, changing positions, and gradually becoming more comfortable with normal movement.
7. A weak "core" is not a simple explanation for back pain. Weak core muscles are often blamed for back pain, but the relationship is much more complicated. People with back pain may actually tense their abdominal and back muscles as a protective response. Constantly bracing or holding tension can sometimes make movement feel more difficult or uncomfortable. Being strong and physically capable is valuable, but there's no need to keep the core muscles clenched throughout the day to protect the back. Learning to move with less fear and unnecessary tension can be just as important as becoming stronger.
8. The back is designed to move and handle load. The spine isn't a fragile structure that simply "wears out" from normal movement. Bending, twisting, lifting, walking, and other forms of movement are normal parts of life. Gradual exposure to movement and loading can help build confidence, capacity, and strength. If certain activities have been avoided because of fear of damaging the back, starting at a manageable level and gradually working toward those activities can help. The goal isn't to protect the back from every sensation. It's to help the body become more capable and the brain less fearful of movement.
9. Pain flare-ups don't necessarily mean that the back has been damaged. Flare-ups can be painful and frightening, but an increase in pain doesn't automatically mean that new tissue damage has occurred. Flare-ups can be influenced by many factors, including poor sleep, stress, worry, low mood, inactivity, increased physical activity, or doing something the body isn't accustomed to. When a flare-up occurs, try not to automatically treat it as a new injury. Stay calm, adjust activity if necessary, and gradually return to normal movement as able. Learning what influences flare-ups can also help make them less frightening and easier to manage.
   
10. Injections, surgery, and opioids aren't usually long-term solutions for chronic nonspecific back pain. Injections, surgery, and medications - including opioids - may have a role in carefully selected situations, but they aren't routinely effective long-term solutions for nonspecific chronic low back pain. They can also carry risks and unwanted effects. For many people, a broader approach that includes education, physical activity, exercise, self-management, and addressing psychological and social factors can be more useful than relying on a single treatment. The goal isn't simply to find a treatment that makes the pain disappear. It's to improve function, build confidence, and regain more control over daily life.

When should you seek medical care?
Most low back pain isn't caused by a serious condition. However, some symptoms warrant prompt medical evaluation.

Seek medical attention if back pain is accompanied by:

• New or progressive weakness in a leg
• Loss of bladder or bowel control
• Numbness around the groin, buttocks, or inner thighs
• Fever or signs of infection
• Unexplained weight loss
• Significant trauma
• Severe or rapidly worsening symptoms
• Other symptoms that are concerning or unusual

When in doubt, talk with a qualified healthcare professional who can evaluate the symptoms and help determine whether further testing is appropriate.
 
The bottom line
An MRI can show changes in the spine. It can't tell someone how much pain they should feel.

Chronic back pain doesn't necessarily mean that the spine is damaged, fragile, or wearing out. Pain can be influenced by many interacting factors, and understanding these factors can change how someone responds to pain.

Movement isn't necessarily the enemy. Pain doesn't always mean harm. And recovery is possible - even when pain has been around for a long time.
The goal isn't to ignore the pain. It's to understand it, respond to it differently, and gradually build the ability to live a meaningful life alongside it. 

Learn more

• 10 Facts Every Person Should Know About Back Pain
• Surgery won't fix my chronic back pain, so what will?
• Endless Pain - ABC News
• Spinal cord stimulation doesn't help with back pain - University of Sydney
• WHO guideline for non-surgical management of chronic primary low back pain
• Ozzy Osbourne: Former surgeon was f***ing insane (7:03)

Research

• Pharmacological treatments for low back pain in adults - Cochrane
• Central sensitization in chronic low back pain: A narrative review
• Low Back Pain Flares: How Do They Differ From an Increase in Pain?
• Psychological interventions for chronic, non-specific low back pain
• Noninvasive Treatments for Low Back Pain - AHRQ
• Appropriate Use of Diagnostic Imaging in Low Back Pain
• Recurrence of low back pain is common
• Cognitive functional therapy - RESTORE 3-year follow-up
• Systematic review of imaging features of spinal degeneration in asymptomatic populations
• Benefits and Harms of Surgery Compared With Non-Surgical Interventions
• RESTORE Clinical Trial for Back Pain
• Communicating with people seeking help for lower back pain - a quiz for providers, but also beneficial for patients.